What is the first-line management strategy for Legg-Calvé-Perthes disease?

The first-line management strategy for Legg-Calvé-Perthes disease is observation. This condition involves avascular necrosis of the femoral head, typically seen in children between the ages of 4 and 8. In many cases, especially when the child is younger and the involvement of the femoral head is less severe, the disease may resolve on its own as the child grows.

During the observation period, the child is monitored for pain and mobility issues while allowing natural progression. Key factors influencing management include the child's age, the extent of the disease at presentation, and the presence of symptoms. Younger children often have a better prognosis and can be effectively managed non-operatively.

The goal of this approach is to minimize interventions while providing the best chance for the femoral head to heal and revascularize over time. Surgical options or other interventions may be considered if the disease progresses, if the child experiences significant symptoms, or if there are concerns about the long-term outcome based on radiographic findings, but these are not the first-line strategies.